胃肠肿瘤手术患者术后急性肾损伤与术前脱水的关系

Relationship between postoperative acute kidney injury and preoperative dehydration in patients undergoing surgery for gastrointestinal tumor

目的评价胃肠肿瘤手术患者术后急性肾损伤与术前脱水的关系。方法择期全麻下行胃肠肿瘤手术患者231例,ASA分级Ⅰ或Ⅱ级,年龄≥18岁。根据术前尿液颜色、比重、渗透压和肌酐计算术前脱水指数,将脱水指数≥3.5定义为脱水,根据改善全球肾脏病预后指南标准定义急性肾损伤。应用logistic回归分析胃肠肿瘤手术患者术后急性肾损伤与术前脱水的关系。结果231例患者中有27例(11.7%)发生术后急性肾损伤,其中13例(48.1%)存在术前脱水。logistic回归分析结果显示,术前脱水是胃肠肿瘤手术患者术后急性肾损伤的独立危险因素(OR值4.03,95%CI为1.72~9.39)。结论术前脱水是胃肠肿瘤手术患者术后急性肾损伤的独立危险因素。

Objective To evaluate the relationship between postoperative acute kidney injury(AKI)and preoperative dehydration in the patients undergoing surgery for gastrointestinal tumor.Methods A total of 231 patients,of American Society of Anesthesiologists physical statusⅠorⅡ,aged≥18 yr,undergoing elective surgery for gastrointestinal tumor with general anesthesia,were enrolled.Preoperative dehydration index was calculated according to preoperative urine color,specific gravity,osmotic pressure and creatinine.Preoperative dehydration was defined as dehydration index≥3.5.AKI was defined according to the Kidney Disease Improving Global Outcomes criteria.Logistic regression analysis was conducted to assess the association between preoperative dehydration and postoperative AKI.Results Of the 231 patients who met our inclusion criteria,27(11.7%)developed postoperative AKI,and 13 patients(48.1%)had preoperative dehydration among the patients developed postoperative AKI.The results of logistic analysis showed that preoperative dehydration was an independent risk factor for postoperative AKI in the patients undergoing surgery for gastrointestinal tumor(OR=4.03,95%confidence interval 1.72-9.39).Conclusion Preoperative dehydration is an independent risk factor for postoperative AKI in the patients undergoing surgery for gastrointestinal tumor.